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Leadership in public health

Article  in  Indian Journal of Public Health · July 2018

DOI: 10.4103/ijph.IJPH_306_18

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Editorial

Leadership in Public Health

The concept of leadership is as old as the origin of the human and other influencers. The scope of leadership expands as
race. Be it a team or a community or a nation, a leader has they move into senior positions by virtue of the length of
always been required for the progress of the society, for service and not because they have acquired the leadership
achieving a desired goal or even solving a problem faced by skills. An average health professional reaching leadership
the masses. In the process, while some became a leader because position acquires these skills, essentially by hit and trial, by
of the dynasty, they were born in such as kings, chieftains, observing others, and through individual driven self‑learning
and headmen, some were chosen and made leaders because of by reading or taking up some available courses.[3] Thus, there
their vision and charismatic personality they possessed such as is a strong feeling that public health organizations should
political leaders, corporate leaders, and military commanders. engage in building leadership capacity at every level wherever
Leaders, who excelled in their field and accomplished the tasks possible. The Lancet Commissioners identified leadership as
even beyond their assigned roles, are remembered as great one of the global systemic failures and recommended major
leaders. Effective leadership is a vital component of health‑care reforms of the health professionals’ education setting up a new
systems and has an extensive range of functions in improving professionalism for the 21st  century, which should promote
organizational effectiveness and efficiency. Leadership is a quality, embrace teamwork, uphold a strong service ethics, and
process whereby an individual influences a group of individuals be centered around the interests of patients and populations.[4]
to achieve a common goal. This wide‑ranging contexts, within which public health leaders
need to function, may require a reconceptualization of
Public health of today is at a crossroad and is in need of a leader
professional training and support mechanisms.[5]
who can help materialize the true public health, as defined by
Acheson, i.e., to prevent disease, prolong life, and promote There are some institutions in the country which offer in‑service
health through the organized efforts of the society.[1] The leader leadership and strategic management courses with funding
is expected to be a person who has a clear understanding of from Government of India, World Health Organization, or
the goal, is efficient at health decision‑making, is able to self‑payment. There are also established in‑service training
communicate and motivate all agencies under command to institutes at the national, state, divisional and district level.
work as a team and is able to show an attributable improvement However, these efforts need to be mainstreamed in both basic
in the health of a population or community.[2] The presence and in‑service training.
of competent leaders is crucial to solving unprecedented
In India, diseases, such as polio, guinea worm disease, yaws,
public health challenges and achieving progress in the field.
and tetanus, have been eradicated. Many of the health indicators
In the current health‑care sector where there is rapid change,
such as life expectancy, infant mortality rate, and maternal
leadership is the key to manage increasing demand, with
mortality rate have shown marked improvement in the previous
limited resources. Lack of effective leadership in health
decades. However, these are still far behind the global average.
coupled with a weak public health capacity is one of the
The burden of communicable diseases continues to be high
bottlenecks in achieving the targets and health goals.
but the leading causes of death now, are noncommunicable
The medical curricula at undergraduate and postgraduate diseases. The epidemiological transition is being fueled by
levels lack the managerial and leadership teaching. Public the social and economic determinants such as globalization;
Health Administration is included to some extent in the  MD unplanned and unregulated urbanization; changing lifestyles;
(Preventive and Social Medicine)/Diploma in Public Health climate change and air pollution; and increasing influence of
courses. This leaves a big gap in managerial and leadership media and advertising. Great disparities between the rich and
skills among the doctors as they reach senior positions. All the the poor, between urban dwellers and rural dwellers, in access to
doctors play a leadership role right from their first assignment health services, continue to exist in the society. The health‑care
while working in a team of staff with them and managing system is overstretched, and the cost of health care is high.[6]
their own clinical work and dealing with their attendants
The scope of public health is massive and limitless. The
challenges, it poses are complex and intricate. The public
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DOI:
10.4103/ijph.IJPH_306_18 How to cite this article: Srivastava VK, Kunwar R. Leadership in public
health. Indian J Public Health 2018;62:165-6.

© 2018 Indian Journal of Public Health | Published by Wolters Kluwer - Medknow 165
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 Srivastava and Kunwar: Leadership in Public Health

health challenges faced by developing nations are substantially analytical thinking, communication, visioning of potential
more than that faced by developed nations. Majority of the future, ethical decision‑making and taking decisive action;
developing world still have their public health infrastructures legal and political competencies for effective negotiations;
in forming a state; their monetary resources are meager and not transorganizational competencies for garnering support from
adequate to bear the cost of expenditure on health; their health agencies beyond the organization or system boundaries; and
workers many of whom are not adequately trained, are not competencies related to team leadership and dynamics for
enough in numbers to provide adequate health coverage. Many building capacity to develop integrated systems to accomplish
of these nations have a high burden of largely preventable mutual objectives.[10]
and treatable conditions. Poor maternal and child health
exacerbated by malnutrition and poverty are still rampant. Leadership in public health is a demanding task and its need
Inequality in health‑care access is markedly high.[7] today is more than it ever was. It needs a person – preferred but
not necessarily a public health practitioner – who is competent,
Sustainable Development Goals, built on the success of is ready to take risks and utilize opportunities, has a vision,
Millennium Development Goals, now cover all walks of life is charismatic, and is able to lead his team successfully in
including poverty, hunger, health, education, climate change, materializing the goal of public health. However, for the
gender equality, water, sanitation, energy, urbanization, leadership to be effective, it must be built on a solid foundation
environment, and social justice. There is hardly any field of a consisting of a clear mission, a vision for the future, a specific
man’s life which has remained untouched and not included in strategy, and a culture conducive to success.
the gambit of public health. In other words, affecting all stages
of human life, covering all aspects of man and its surrounding, V. K. Srivastava1, R. Kunwar2
entwined around the intricacies of the society, and dealing Ex. Professor of Social and Preventive Medicine, KG’s Medical University,
1

with a multitude of stakeholders, the public health of today is Lucknow and Chairperson, Organizing Committee, 62nd Annual National
posing a serious challenge for all public health practitioners. Conference of Indian Public Health Association, 2Professor of Community
Medicine, TS Misra Medical College, Lucknow, UP.
However, the practice of public health is not easy. As is E‑mail: vinods51@hotmail.com
often the case, the good work of its practitioner is rarely
recognized. But, whenever, there is an outbreak or a massive References
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166 Indian Journal of Public Health ¦ Volume 62 ¦ Issue 3 ¦ July‑September 2018

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